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鼓室成形术中软骨加固移植物与筋膜移植物的比较

Cartilage reinforcement graft versus fascia graft in tympanoplasty.

作者信息

Ocak Emre, Beton Süha, Taş Vedat, Meço Cem

出版信息

Turk J Med Sci. 2017 Aug 23;47(4):1124-1127. doi: 10.3906/sag-1602-151.

Abstract

Background/aim: The purpose of this study was to compare cartilage reinforcement graft results with temporalis fascia graft alone in terms of hearing and anatomical outcomes in tympanoplasty. Materials and methods: Patients who underwent tympanoplasty with/without ossiculoplasty and/or mastoidectomy at a university hospital from 2006 through 2013 were reviewed retrospectively. The patients were divided into those grafted with temporalis muscle fascia alone and with fascia reinforced with cartilage. The postoperative air bone gap, gain in hearing thresholds, and graft status were evaluated for each group. Results: The study subjects included 179 patients. There were 82 patients in the fascia group and 97 patients in the cartilage group. Successful hearing results were elicited in 79.2% of the fascia group and 85.5% of the cartilage group. There was no significant difference in overall graft success. The graft was intact in 82.9% of the fascia group and 86.5% of the cartilage group. Conclusion: In this comparative study the use of cartilage to reinforce the temporalis muscle fascia was analyzed, showing better hearing and anatomical results than sole use of fascia in tympanoplasty both for primary and revision cases. Thus, in the light of our results, when performing tympanoplasty we recommend the use of cartilage reinforcement grafting whenever needed and indicated.

摘要

背景/目的:本研究旨在比较在鼓室成形术中使用软骨加强移植与单独使用颞肌筋膜移植在听力和解剖学结果方面的差异。材料与方法:回顾性分析2006年至2013年在某大学医院接受鼓室成形术(伴或不伴听骨链成形术和/或乳突切除术)的患者。将患者分为单独使用颞肌筋膜移植组和使用软骨加强筋膜移植组。评估每组患者术后的气骨导间距、听力阈值改善情况及移植状态。结果:研究对象包括179例患者。筋膜组有82例患者,软骨组有97例患者。筋膜组79.2%的患者听力结果成功,软骨组为85.5%。总体移植成功率无显著差异。筋膜组82.9%的移植片完整,软骨组为86.5%。结论:在这项对比研究中,分析了使用软骨加强颞肌筋膜的情况,结果显示无论是初次手术还是翻修手术,在鼓室成形术中使用软骨加强移植比单独使用筋膜能获得更好的听力和解剖学结果。因此,根据我们的研究结果,在进行鼓室成形术时,我们建议在需要且有指征时使用软骨加强移植。

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